Administrative Page for
Blue Shield Employer Group Plans
Blue Shields Website forms & Applications
Compare one plan to another and even this year to last year!
If any links require log in, or you don’t find what you need, just email us [email protected] and we will get you the form that you need.
You can also check there or just email us [email protected] .
Click here for Current Sales and Enrollment Information.
- Compare/add/edit/delete subscribers and dependents to calculate quotes..
Quotit Enrollment, Applications & Misc. Forms Scroll down the page to Blue Shield
Find EOC’s – Evidence of Coverage for Employee Distribution
eligibility support line at 800-303-5921
For All Renewal Forms and Benefit Summaries.
GROUP SERVICES: Confirm Member Enrollment and Terminations Phone – 800-325-5166, option 1 Producer’s Online Client List: https://www.blueshieldca.com/producer
SUBMITTING GROUP CHANGES/REQUEST FOR CHANGE FORMS: Fax – 209-367-6603 (please retain your fax confirmation) EMAIL:
SUBMITTING NEW EMPLOYEE APPLICATION & SUBSCRIBER/MEMBER CHANGES: Fax – 209-367-6475 EMAIL:
BILLING QUESTIONS? Phone – 800-325-5166
groups 1-100, Group Employer Services: (800) 325-5166
View a Quick Reference Guide
UNDERWRITING QUESTIONS/RECERTIFICATION STATUS: 888-834-4263
CLAIMS AND BENEFIT QUESTIONS: PPO DMHC Plans – 800-200-3242 HMO/POS – 800-424-6521
PHARMACY/DRUG COVERAGE QUESTIONS? – 800-535-9481
Cal – COBRA: Phone – 800-228-9474.
Get Started on Employer Connection Plus
- Intro to Employer Connection (1:30)
- Grant Account Access for a New User (1:45)
- Modify or Delete a User's Access (1:33)
Quotit Paper - PDF
ONLINE Enrollment Tools - Instructions
Email us for a web link to get your applications going with Pro Apply
PRO Apply: Flyer (PDF)
PRO Apply: Quick Guide (PDF)
PRO Apply Intake Form (PDF)
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Steve @ Blue Shield Headquarters
Visit our Blue Shield Medi Gap Webpage
PPO Basics Video
HMO Basics Video